THE CHIARI PELVIC OSTEOTOMY A LONG-TERM REVIEW OF CLINICAL AND RADIOGRAPHIC RESULTS

We have reviewed a series of 94 Chiari pelvic osteotomies carried out from 1966 to 1982. In 83 hips the indication for surgery had been pain, and of these patients 73 (88%) had appreciable relief within one year of operation. The other 11 hips were all in children and were painless; in them the osteotomy had successfully stabilised progressive subluxation of the hip. At review after a mean follow-up of 10 years (range, 2 to 18 years) 68 previously painful hips were reassessed. Although function of the hips had deteriorated slowly with time, four of the seven cases with 18 years' follow-up had good function and only minor symptoms

Navigating the stigmatised identities of poverty in austere times: Resisting and responding to narratives of personal failure

© 2015, © The Author(s) 2015. Behavioural explanations of poverty and disadvantage have figured heavily in political rhetoric in the era of austerity, as a means to understand trajectories into poverty and subsequent relationships between benefit claimants and the state. These discourses are not restricted to political debate, as previous studies demonstrate they impact upon public consciousness and structure the ways that the general public think about poverty, as well as shaping the ways in which people living on low incomes are treated. Drawing upon the testimonies of 62 people in England and Scotland experiencing poverty, this article seeks to understand our participants’ responses to these discourses, in particular: how these behavioural explanations impact upon their understanding of their own situations, as well as their self perceptions; how these discourses shape their relationships with others, in terms of their experience of disrespect; and how participants seek to dissociate themselves from their stigmatising implications

Crystalline inclusion of wheel-and-axle diol hosts featuring benzo[b]thiophene units as a lateral construction element

By applying the “wheel-and-axle” host concept and incorporating a previously developed heteroaromatic substitution strategy, a new type of diol host featuring two di(benzo[b]thien-2-yl)hydroxymethyl units attached to both ends of a central ethynylene (3) and 1,4-phenylene (4) moiety is reported. The syntheses of the host compounds are described, and solvent inclusion formation via crystallization has extensively been studied showing a remarkable inclusion capability of the compounds. X-ray diffraction analysis of relevant crystal structures have been performed and comparatively discussed. Vapor sorption behavior of the compounds as solid receptor films coated on a quartz crystal microbalance considering a variety of solvent vapors has been scrutinized, indicating potential application as mass sensitive materials

Experienced discrimination amongst European old citizens

This study analyses the experienced age discrimination of old European citizens and the factors related to this discrimination. Differences in experienced discrimination between old citizens of different European countries are explored. Data from the 2008 ESS survey are used. Old age is defined as being 62 years or older. The survey data come from 28 European countries and 14,364 old-age citizens. Their average age is 72 years. Factor analysis is used to construct the core variable ‘experienced discrimination’. The influence of the independent variables on experienced discrimination is analysed using linear regression analysis. About one-quarter of old European citizens sometimes or frequently experience discrimination because of their age. Gender, education, income and belonging to a minority are related to experienced age discrimination. Satisfaction with life and subjective health are strongly associated with experienced age discrimination, as is trust in other people and the seriousness of age discrimination in the country. Large, significant differences in experienced discrimination due to old age exist between European countries. A north-west versus south-east European gradient is found in experienced discrimination due to old age. The socio-cultural context is important in explaining experienced age discrimination in old European citizens. Old-age discrimination is experienced less frequently in countries with social security arrangements. Further research is needed to understand the variation in (old) age discrimination between European countries. Measures recommended include increasing public awareness about the value of ageing for communities and changing public attitudes towards the old in a positive way

Validity and responsiveness of the Clubfoot Assessment Protocol (CAP). A methodological study

BACKGROUND: The Clubfoot Assessment Protocol (CAP) is a multi dimensional instrument designed for longitudinal follow up of the clubfoot deformity during growth. Item reliability has shown to be sufficient. In this article the CAP's validity and responsiveness is studied using the Dimeglio classification scoring as a gold standard. METHODS: Thirty-two children with 45 congenital clubfeet were assessed prospectively and consecutively at ages of new-born, one, two, four months and two years of age. For convergent/divergent construct validity the Spearman's correlation coefficients were calculated. Discriminate validity was evaluated by studying the scores in bilateral clubfeet. The floor-ceiling effects at baseline (untreated clubfeet) and at two years of age (treated clubfeet) were evaluated. Responsiveness was evaluated by using effect sizes (ES) and by calculating if significant changes (Wilcoxons signed test) had occurred between the different measurement occasions. RESULTS: High to moderate significant correlation were found between CAP mobility I and morphology and the Dimeglio scores (r(s )= 0.77 and 0.44 respectively). Low correlation was found between CAP muscle function, mobility II and motion quality and the Dimeglio scoring system (r(s )= 0.20, 0.09 and 0.06 respectively). Of 13 children with bilateral clubfeet, 11 showed different CAP mobility I scores between right and left foot at baseline (untreated) compared with 5 with the Dimeglio score. At the other assessment occasions the CAP mobility I continued to show higher discrimination ability than the Dimeglio. No floor effects and low ceiling effects were found in the untreated clubfeet for both instruments. High ceiling effects were found in the CAP for the treated children and low for the Dimeglio. Responsiveness was good. ES from untreated to treated ranged from 0.80 to 4.35 for the CAP subgroups and was 4.68 for the Dimeglio. The first four treatment months, the CAP mobility I had generally higher ES compared with the Dimeglio. CONCLUSION: The Clubfoot Assessment Protocol shows in this study good validity and responsiveness. The CAP is more responsive when severity ranges between mild – moderate to severe, while the Dimeglio focuses more on the extremes. The ability to discriminate between different mobility status of the right and left foot in bilaterally affected children in this population was higher compared with the Dimeglio score implicating a better sensitivity for the CAP

Active ageing, pensions and retirement in the UK

The ageing population has led to increasing concerns about pensions and their future sustainability. Much of the dominant policy discourse around ageing and pension provision over the last decade has focussed on postponing retirement and prolonging employment. These measures are central to productive notions of ‘active ageing’. Initially the paper briefly sets out the pension developments in the UK. Then it introduces active ageing and active ageing policy, exploring its implications for UK pension provision. It demonstrates that a more comprehensive active ageing framework, which incorporates a life-course perspective, has the potential to assist the UK to respond to the challenges of an ageing population. In doing so it needs to highlight older people as an economic and social resource, and reduce barriers to older people’s participation in society

Understanding unequal ageing: towards a synthesis of intersectionality and life course analyses

Intersectionality has received an increasing amount of attention in health inequalities research in recent years. It suggests that treating social characteristics separately—mainly age, gender, ethnicity, and socio-economic position—does not match the reality that people simultaneously embody multiple characteristics and are therefore potentially subject to multiple forms of discrimination. Yet the intersectionality literature has paid very little attention to the nature of ageing or the life course, and gerontology has rarely incorporated insights from intersectionality. In this paper, we aim to illustrate how intersectionality might be synthesised with a life course perspective to deliver novel insights into unequal ageing, especially with respect to health. First we provide an overview of how intersectionality can be used in research on inequality, focusing on intersectional subgroups, discrimination, categorisation, and individual heterogeneity. We cover two key approaches—the use of interaction terms in conventional models and multilevel models which are particularly focussed on granular subgroup differences. In advancing a conceptual dialogue with the life course perspective, we discuss the concepts of roles, life stages, transitions, age/cohort, cumulative disadvantage/advantage, and trajectories. We conclude that the synergies between intersectionality and the life course hold exciting opportunities to bring new insights to unequal ageing and its attendant health inequalities